Firefighters can struggle with a range of emotional or mental trauma after responding to large-scale, stressful events.

When the toils of the job become too intense, San Francisco police can take advantage of in-house mental health services to help cope with stress before it escalates into something much worse.

Firefighters in The City want the same treatment but are being rebuffed -- there is no room for a $100,000 program in the department's $344 million annual budget.

Post-traumatic stress disorder or mental illness are of particular concern to first responders, and can derive from extremely stressful situations in the daily job that build over time or even acute situations such as last summer's crash of Asiana Airlines Flight 214 on the tarmac at San Francisco International Airport.

Currently, firefighters dealing with mental or emotional trauma can seek treatment through their health insurance or meet with the stress unit, which consists of two firefighters who received extra training and classes to handle such matters.

The Police Department also has a stress unit, and it can refer cops to doctors who specialize in addressing first responders' needs once it's determined more help is needed, said Shon Buford, a firefighter and treasurer of the San Francisco Fire Fighters Local 798 union.

For the past two budget cycles, firefighters have been asking for $100,000 for those same extra resources, but "we've been cutting our budget for a long time," Buford said.

All city employees can access some level of psychiatric care, however The City's specialized mental health offerings to firefighters lag behind some other big American cities.

Other major fire departments, such as New York City's, screen potential firefighters for mental illness. Current New York firefighters also visit with a mental health professional as part of their annual health checkup, SFFD physician Dr. Ramon Terrazas recently told the San Francisco Fire Commission.

"It's a machine," Terrazas said of New York's in-house medical services, beefed up in large part after 343 first responders were killed in the Sept. 11 terrorist attacks.

A backlog in San Francisco firefighters' annual health checkups is one reason the stress unit's requests are going unfulfilled. Firefighters are supposed to undergo an annual exam with Terrazas that ensures their lungs are fit enough to wear oxygen masks and otherwise handle the rigors of the job. Terrazas also checks for other work-related health issues peculiar to firefighting that a general practitioner might miss, Buford said.

But due to budgetary constraints, the department's 1,400 firefighters and paramedics have their annual health check every three years, and no checks have been performed since 2009.

An extra $1.2 million was put into the Fire Department's budget this year to start clearing the backlog in health checks, said Mindy Talmadge, a department spokeswoman.

That meant even less of a chance to beef up the stress unit.

"We've asked for a lot of additional funding this year and we've gotten some of it," she said. "But that extra $100,000 just isn't something we have access to."

Terrazas has about $3 million available to him every year and a staff of three, including himself. To do his job fully, he told the Fire Commission he would need a $5 million budget.